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High Pyridine Generation in Ceftazidime-Icodextrin Admixtures Used to Treat Peritoneal Dialysis-associated Peritonitis.
Clin Ther. 2019 11; 41(11):2446-2451.CT

Abstract

PURPOSE

To investigate the amount of pyridine generated from degradation of ceftazidime in icodextrin peritoneal dialysis (PD) solutions.

METHODS

PD solutions that contained 1 and 1.5 g of ceftazidime were stored at 25 °C for 12 hours and then at 37 °C for 14 hours. An aliquot was withdrawn at predefined time points and analyzed for the concentrations of ceftazidime and pyridine.

FINDINGS

The amount of pyridine generated was >225% and 400% of its maximum recommended daily exposure in the 1- and 1.5-g ceftazidime-PD admixtures, respectively.

IMPLICATIONS

Until these results are confirmed with appropriate in vivo studies, intermittent intraperitoneal dosing of ceftazidime admixed with icodextrin should be used with caution and appropriate clinical monitoring or a suitable alternative antibiotic should be used.

Authors+Show Affiliations

Department of Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.Department of Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.Department of Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia; Department of Pharmacy and Jack Jumper Allergy Program, Royal Hobart Hospital, Hobart, Tasmania, Australia.Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia; Peritoneal Dialysis Unit, Regional Dialysis Centre, Blacktown Hospital, Blacktown, New South Wales, Australia.Peritoneal Dialysis Unit, Regional Dialysis Centre, Blacktown Hospital, Blacktown, New South Wales, Australia; Department of Renal Medicine, Nepean Hospital and Nepean Clinical School, The University of Sydney, Kingswood, New South Wales, Australia.Department of Nephrology, Royal Hobart Hospital, Hobart, Tasmania, Australia.Department of Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.Department of Pharmacy, School of Medicine, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: rahul.patel@utas.edu.au.

Pub Type(s)

Letter
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31575441

Citation

Kaur, Harpreet, et al. "High Pyridine Generation in Ceftazidime-Icodextrin Admixtures Used to Treat Peritoneal Dialysis-associated Peritonitis." Clinical Therapeutics, vol. 41, no. 11, 2019, pp. 2446-2451.
Kaur H, Harmanjeet H, Wanandy T, et al. High Pyridine Generation in Ceftazidime-Icodextrin Admixtures Used to Treat Peritoneal Dialysis-associated Peritonitis. Clin Ther. 2019;41(11):2446-2451.
Kaur, H., Harmanjeet, H., Wanandy, T., Castelino, R. L., Sud, K., Jose, M. D., Peterson, G. M., & Patel, R. P. (2019). High Pyridine Generation in Ceftazidime-Icodextrin Admixtures Used to Treat Peritoneal Dialysis-associated Peritonitis. Clinical Therapeutics, 41(11), 2446-2451. https://doi.org/10.1016/j.clinthera.2019.08.021
Kaur H, et al. High Pyridine Generation in Ceftazidime-Icodextrin Admixtures Used to Treat Peritoneal Dialysis-associated Peritonitis. Clin Ther. 2019;41(11):2446-2451. PubMed PMID: 31575441.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High Pyridine Generation in Ceftazidime-Icodextrin Admixtures Used to Treat Peritoneal Dialysis-associated Peritonitis. AU - Kaur,Harpreet, AU - Harmanjeet,Harmanjeet, AU - Wanandy,Troy, AU - Castelino,Ronald L, AU - Sud,Kamal, AU - Jose,Matthew D, AU - Peterson,Gregory M, AU - Patel,Rahul P, Y1 - 2019/09/28/ PY - 2019/07/08/received PY - 2019/08/12/revised PY - 2019/08/29/accepted PY - 2019/10/3/pubmed PY - 2020/7/7/medline PY - 2019/10/3/entrez KW - ceftazidime KW - peritoneal dialysis KW - peritonitis KW - pyridine KW - stability KW - toxicity SP - 2446 EP - 2451 JF - Clinical therapeutics JO - Clin Ther VL - 41 IS - 11 N2 - PURPOSE: To investigate the amount of pyridine generated from degradation of ceftazidime in icodextrin peritoneal dialysis (PD) solutions. METHODS: PD solutions that contained 1 and 1.5 g of ceftazidime were stored at 25 °C for 12 hours and then at 37 °C for 14 hours. An aliquot was withdrawn at predefined time points and analyzed for the concentrations of ceftazidime and pyridine. FINDINGS: The amount of pyridine generated was >225% and 400% of its maximum recommended daily exposure in the 1- and 1.5-g ceftazidime-PD admixtures, respectively. IMPLICATIONS: Until these results are confirmed with appropriate in vivo studies, intermittent intraperitoneal dosing of ceftazidime admixed with icodextrin should be used with caution and appropriate clinical monitoring or a suitable alternative antibiotic should be used. SN - 1879-114X UR - https://www.unboundmedicine.com/medline/citation/31575441/High_Pyridine_Generation_in_Ceftazidime_Icodextrin_Admixtures_Used_to_Treat_Peritoneal_Dialysis_associated_Peritonitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0149-2918(19)30474-6 DB - PRIME DP - Unbound Medicine ER -